中药益气养阴清热利湿法配合恩替卡韦对慢性乙型肝炎HBeAg血清学转换的影响

Effect of Integrative Treatment of Benefiting Qi and Yin-nourishing and Heat-clearing and Dampness-dispelling Method and Entecavir to HBeAg Seroconversion in Chronic Hepatitis B

目的:观察中药益气养阴清热利湿法配合恩替卡韦治疗HBeAg阳性慢性乙型肝炎对HBeAg血清学转换等指标的影响。方法:选取2015年3月—2017年3月辽宁中医药大学附属医院感染科诊治的HBeAg阳性气阴两虚兼湿热型慢性乙型肝炎患者120例为研究对象,按照随机数字表法将患者分为研究组及对照组,各60例。对照组患者给予恩替卡韦0.5 mg空腹口服,每日1次,研究组在恩替卡韦的基础上加用益气养阴清热利湿的中药方剂治疗,两组疗程均为48周。比较治疗48周后两组临床疗效、HBeAg血清学转换率,HBeAg阴转率。HBV DNA阴转率,并评价肝功能等指标。结果:研究组总有效率为93.33%,对照组总有效率为80.00%,比较差异具有统计学意义(P<0.05)。研究组在治疗后HBeAg血清转换率为25.00%,HBeAg阴转率为28.33%,HBV DNA阴转率为95.00%,均优于对照组的18.33%、20.00%、81.67%,两组比较差异具有统计学意义(P<0.05);研究组谷丙转氨酶(ALT)等肝功能指标改善情况均优于对照组,差异具有统计学意义(P<0.05)。两组患者均未发现明显不良反应。结论:中药益气养阴清热利湿法配合恩替卡韦治疗HBeAg阳性气阴两虚兼湿热型慢性乙型肝炎,可有效提高临床疗效及HBeAg血清学转换率、HBeAg阴转率、HBV DNA阴转率,能更好地改善肝功能。

Objective:To observe the clinical effect on integrative treatment of benefiting Qi and Yin-nourishing and heat-clearing and dampness-dispelling method and Entecavir to indicators such as HBeAg Seroconversion,etc in patients with HBeAg-positive chronic hepatitis B.Methods:A total of 120 cases of patients with Qi and Yin deficiency and damp-heat syndrome who were treated in The Hospital of Liaoning University of Traditional Chinese Medicine clinical laboratory center from March 2015 to March 2017,were divided into study group and control group(60 cases in each group)by random number table method.Patients in the control group took Entecavir Tablets on an empty stomach(0.5 mg,once per day)combined with traditional Chinese medicine treatment benefiting Qi and Yin-nourishing and heat-clearing and dampness-dispelling method,while those in the study group took Entecavir Tablets alone.The therapeutic course for two groups was 48 weeks.We evaluated the therapeutic effect.HBeAg seroconversion rate,HBeAg negative conversion rate,HBV DNA negative conversion rate and liver function were compared after 48 weeks treatment.Results:After 48 weeks treatment,the total effective rate of the study group was 93.33%(56/60)and that in the control group was 80.00%(48/60).The difference was statistically significant(P<0.05).HBeAg seroconversion rate,HBeAg negative conversion rate and HBV DNA negative conversion were 25.00%,28.33%and 95.00%in the study group,which were significantly higher than those of the control group(18.33%,20.00%,81.67%).The difference was statistically significant(P<0.05).Improvement of liver function indicators such as alanine aminotransferase(ALT),etc in study group were higher than those of in control group.The difference was statistically significant(P<0.05).No obvious adverse reaction occurred in the two groups.Conclusion:Integrative treatment of benefiting Qi and Yin-nourishing and heat-clearing and dampness-dispelling method and Entecavir could elevate the clinical effects and the HBeAg seroconversion rate,HBeAg negative conversion rate,HBV DNA negative conversion rate and liver function in HBeAg-positive Qi and Yin deficiency and damp-heat syndrome patients′treatment.